- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.04 / $226.46 / $49,582.49
| Facility | | $38.04 | $226.46 | $49,582.49 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $16.98 / $16.98 / $289.35
| Facility | 26 | $16.98 | $16.98 | $289.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.91 / $38.04 / $210.00
| Professional | | $30.91 | $38.04 | $210.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.77 / $16.98 / $63.52
| Professional | 26 | $11.77 | $16.98 | $63.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.89 / $22.31 / $50.94
| Professional | TC | $17.89 | $22.31 | $50.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.71 / $46.73 / $70.18
| Professional | | $34.71 | $46.73 | $70.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.46 / $20.14 / $30.07
| Professional | 26 | $15.46 | $20.14 | $30.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.04 / $28.29 / $44.33
| Professional | TC | $18.04 | $28.29 | $44.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.54 / $28.98 / $37.72
| Professional | | $22.54 | $28.98 | $37.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.53 / $63.34 / $72.66
| Professional | | $56.53 | $63.34 | $72.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.32 / $27.10 / $32.61
| Professional | 26 | $20.32 | $27.10 | $32.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $32.15 / $37.01 / $42.81
| Professional | TC | $32.15 | $37.01 | $42.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.25 / $37.17 / $59.99
| Professional | | $34.25 | $37.17 | $59.99 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.68 / $15.29 / $23.88
| Professional | 26 | $14.68 | $15.29 | $23.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.19 / $22.37 / $36.08
| Professional | TC | $17.19 | $22.37 | $36.08 |